NPIMap

Individual provider Active NPI

Jeffrey H Declaire, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Rochester, MI
National Provider Identifier
1265442446
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
4301045096 Issued in MI
Practice address
1135 W University Dr
Suite 450
Rochester, MI 48307-1871
Phone
(248) 650-2400
Fax
(248) 650-4596
NPI assigned
Aug 9, 2006
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 4301045096 MI Primary

Addresses

Primary practice location

1135 W University Dr
Suite 450
Rochester, MI 48307-1871

Mailing address

1135 W University Dr
Suite 450
Rochester, MI 48307-1871
Phone (248) 650-2400

Other identifiers 2

IdentifierTypeStateIssuer
0632203OtherMIBLUE CROSS BLUE SHIELD
1265442446MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060407000118 MI Practitioner - Orthopedic Surgery 7618986316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1101 W University Dr
Crittenton Hospital Medical Center
Rochester, MI 48307-1863
Phone (248) 652-5000

1135 W University Dr
Rochester, MI 48307-1871

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement154
Lower limb (leg) arthroscopy (minimally invasive joint repair)43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301045096MIMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Rochester Hospital CurrentSince May 1, 2020 Accepting new patients
Henry Ford Health Rochester Hospital Current Accepting new patients
Henry Ford Health Rochester Hospital CurrentSince May 1, 2020 Accepting new patients
Michigan Institute for Advanced Surgery Center, LLC Current Accepting new patients
Henry Ford Health Rochester Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1135 W University Dr
Ste 225
Rochester Hills, MI 48307
Phone (248) 652-9450

1135 W University Dr
Ste 450
Rochester Hills, MI 48307
Phone (248) 650-2400

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

1135 W University Dr
Rochester Hls, MI 48307
Phone (248) 650-2400

1135 W University Dr
Ste 330
Rochester Hls, MI 48307
Phone (248) 650-1510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
  • Direct secure messaging: jdeclaire1124795@direct.hfhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1265442446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR",
            "address_2": "SUITE 450",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071871",
            "telephone_number": "248-650-2400",
            "fax_number": "248-650-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR",
            "address_2": "SUITE 450",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071871",
            "telephone_number": "248-650-2400",
            "fax_number": "248-650-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLAIRE",
        "first_name": "JEFFREY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MI",
            "license": "4301045096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0632203",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265442446",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.